Inflammation of the tendons is caused by various conditions of the performed activities. Usually it is a result of one-sided mechanical overloading. This kind of illness is occurring basically in all work activities during missing or disrupted adaptation of the tissues to the working stress. It is often a handicap affecting the tendons and muscles of the forearm/arm.
Tendon illnesses can be divided according to the anatomical structure. The illness of the tendon sheath is called peritendinitis or tenosynovitis or tendovaginitis. If the tendon tissue is affected in the area of the attachment to the bone, then we talk about enthesopathy.
There is a common connection to the mechanical burden for this group of illnesses. The muscles is fixed to the bone thanks to the tendon, which transfers the muscle contraction. The tendon is because of higher level of collagen very firm structure resisting bigger mechanical stress than the muscles is able to create. We also meet more often with injury of the muscle than injury of the tendon or its attachment during extreme and sudden contraction.
Repeated mechanical overload of the functioning “unit” is a characteristic common problem of the muscle-tendon-tendon attachment which leads to acute and chronic illness.
The acute form is accompanied by inflammation changes of the tendon sheath. That is usually regarded as a painful syndrome. Patients describe the pain spreading in the area of the tendon attachment and at the same time it is calm.
The main risk is in a excessive overload of the muscles without sufficient regeneration. It is mainly caused by long term overloading and repeated motions which happens for example during tennis, playing on guitar, kneading the dough and others.
This illness is usually not manifested suddenly, but generally it develops gradually. First you feel higher sensitivity (painfulness) and itching in the area of the inflammation. It is also usually followed by edema and skin redness of the affected area, which is warmer by the touch and usually very sensitive. The pain occurs especially while moving, but as we mentioned above, it is not unusual to feel the pain even during peaceful regime. Purulent inflammation of the tendons is then usually caused by some associated illness in the body.
It is usually recommended to reduce the activity of the muscle whose tendon is affected, therefore cast fixation or brace on the affected area is a common process. Rehabilitation is usually prescribed after the tendon is healed. The treatment can be supported also with focused shock wave therapy, which has a anti-inflammatory effects. Radial shock wave therapy has then better effect not directly on the tendons, but on the muscles, which helps to adjust the muscle tension. As a addition to the therapy you can apply also healing creams with anti-inflammatory effects.
Rehabilitation of the handicapped arm is important in order to recover the function of the affected area, it also serves as a prevention, so it wouldn’t create any further problems. Physiotherapist will then recommend you based on the complexive kinesiological examination ideal movement therapy including simple stretching exercises. It is also important to focus on your movement stereotypes, which you consciously or unconsciously use during daily activities, and find out which would lead to overload of a certain part.
Surgical solution is rather rare, that is when the affected part of the tendon is removed.
Author: FYZIOklinika physiotherapy Ltd., Prague, Czech Republic
Source: RICHTR, M. Nemoci šlach a šlachových pochev nebo úponů svalů z dlouhodobého nadměrného jednostranného přetěžování. Neurologie pro praxi. 2014; 15(5): 244248.